Table 1 Proposed changes to ERIC strategy labels and/or definitions with rational for changes (proposed changes are in italics)

Use data experts

Involve, hire, and/or consult experts to inform management on the use of data generated by implementation efforts

Involve, hire, and/or consult experts to acquire, structure, manage, report, and use data generated by implementation efforts

We broadened functions of data experts beyond just management of data.

Fund and contract and/or negotiate with vendors for the clinical innovation

Governments and other payers of services issue requests for proposals to deliver the innovation, use contracting processes to motivate providers to deliver the clinical innovation, and develop new funding formulas that make it more likely that providers will deliver the innovation

None

We broadened the name to include the role of negotiation. Having outside assistance to negotiate with EHR vendors can be valuable in addition to payment.

Provide local technical assistance

Develop and use a system to deliver technical assistance focused on implementation issues using local personnel

Develop and use a system to deliver technical assistance within local settings that is focused on implementation issues

We clarified the definition to indicate any technical assistance provided in the local setting, whether provided by local staff or by other on-site individuals.

Audit and provide feedback

Collect and summarize clinical performance data over a specified time period and give it to clinicians and administrators to monitor, evaluate, and modify provider behavior

Develop summaries of clinical performance over a specific time period, often including a comparator, and give it to clinicians and/or administrators. Summary content (e.g., nature of the data, choice of comparator) and their delivery (e.g., mode, format) are designed to modify specifically targeted behavior(s) or actions of individual practitioners, teams, or health care organizations

We broadened the definition to include providing comparator data (benchmark) and to indicate that goal is to modify a targeted behavior and/or action of multiple actors. These facets are listed in ancillary materials but were not included in the published definition.

Use an implementation advisor

Seek guidance from experts in implementation

Seek guidance from experts in implementation, including providing support and training for the implementation work force

We broadened this definition to include providing support and training for facilitators.

Implementation facilitation

A process of interactive problem solving and support that occurs in a context of a recognized need for improvement and a supportive interpersonal relationship

[A] multi-faceted interactive process of problem solving, enabling and supporting individuals, groups and organizations in their efforts to adopt and incorporate innovations into routine practices that occurs in a context of a recognized need for improvement and a supportive interpersonal relationship

The name was changed to specify “implementation” because facilitation is a very broad concept. Implementation facilitation includes practice facilitation, a more specific type of implementation facilitation.

We broadened the definition to acknowledge that facilitation is more than just “interactive problem-solving.”

Assess for readiness and identify barriers and facilitators

Assess various aspects of an organization to determine its degree of readiness to implement, barriers that may impede implementation, and strengths that can be used in the implementation effort

Assess various aspects of an organization to determine its degree of readiness to implement and identify barriers that may impede implementation and strengths that can be leveraged to facilitate the implementation effort

We revised to clarify identification of barriers and leveraging facilitators.

Develop an implementation blueprint

Develop a formal implementation blueprint that includes all goals and strategies. The blueprint should include the following: (1) aim/purpose of the implementation; (2) scope of the change (e.g., what organizational units are affected); (3) timeframe and milestones; and (4) appropriate performance/progress measures. Use and update this plan to guide the implementation effort over time

Develop a formal implementation blueprint that includes all goals and strategies. The blueprint should include the following: (1) aim/purpose of the implementation; (2) scope of the change (e.g., what organizational units are affected); (3) timeframe and milestones; and (4) appropriate performance/progress measures. Use and update this plan to guide the implementation effort over time

We suggest deleting the word “Formal” to include informal as well as formal implementation blueprints. This will include plans that are developed for quality improvement as well as larger formal plans for implementation. Additionally, the definition is expanded to explicitly acknowledge its role in guiding implementation over time.

Organize implementation teams and team meetings

Develop and support teams of clinicians who are implementing the innovation and give them protected time to reflect on the implementation effort, share lessons learned, and support one another’s learning

Develop and support teams of clinicians, staff, patients and other stakeholders who are implementing or may be users of the innovation. Provide protected time for teams to reflect on the implementation progress, share lessons learned, make refinements to plans, and support one another’s learning

We broadened the name to include all possible team members and to include formation of teams as well as meetings. Removing the term clinician allows for a multi-disciplinary team and increases engagement among all team members. We broadened definition to be inclusive of all team members and clarified intent of the definition.

Develop educational materials

Develop and format manuals, toolkits, and other supporting materials in ways that make it easier for stakeholders to learn about the innovation and for clinicians to learn how to deliver the clinical innovation

Develop and format manuals, toolkits, and other supporting materials to make it easier for stakeholders to learn about the innovation and for clinicians to learn how to deliver the clinical innovation. This can include technology-delivered (e.g., online/smartphone-based static or dynamic) content and health messaging

We expanded to include technology-delivered content and messaging.

Conduct educational outreach visits

Have a trained person meet with providers in their practice settings to educate providers about the clinical innovation with the intent of changing the provider’s practice

Have a trained person meet with individuals or teams in their work settings to educate them about the clinical innovation with the intent of changing behavior to reliably use the clinical innovation as designed

We broadened definition to include team members beyond providers and clarified language to more clearly state that this strategy aims to encourage sustained use of the innovation.

Conduct ongoing training

Plan for and conduct training in the clinical innovation in an ongoing way

Plan for and conduct training in the clinical innovation in an ongoing way for all individuals involved with implementation and users of the clinical innovation e.g., clinicians, implementation staff, practice facilitators

We expanded the definition to include all individuals involved.

Conduct educational meetings

Hold meetings targeted toward different stakeholder groups (e.g., providers, administrators, other organizational stakeholders, and community, patient/consumer, and family stakeholders) to teach them about the clinical innovation

Hold meetings targeted toward educating multiple stakeholder groups (i.e., providers, administrators, other organizational stakeholders, community members, patients/consumers, families) about the clinical innovation and/or its implementation

We revised the definition to add specificity about the purpose of the education (the innovation and/or its implementation) and to clarify that education is among multiple types of stakeholders.

Assess and redesign workflow

Observe and map current work processes and plan for desired work processes, identifying changes necessary to accommodate, encourage, or incentivize use of the clinical innovation as designed

New: Added as this work is not reflected in current ERIC strategies.

Create online learning communities

Create an online portal for clinical staff members to share and access resources, webinars, and FAQs related to the specific evidenced-based intervention, and provide interactive features to encourage learning across settings and teams, e.g., regular blogs, facilitated discussion boards, access to experts, and networking opportunities

New: Added as this work is not reflected in current ERIC strategies.

Engage community resources

Connect practices and their patients to community resources outside the practice (e.g., state and county health departments; non-profit organizations; resources related to addressing the social determinants of health; and organizations focused on self-management techniques and support

New: Added as this work is not reflected in current ERIC strategies.